MEDICARE: JESSICA VERONICA GONZALEZ MENDOZA PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NPF95038441	CA

General Provider Information

NPI Number	:	1700731080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA VERONICA GONZALEZ MENDOZA PMHNP

Provider Business Mailing Address
First Line	:	6802 LEMON AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-1530
Country	:	US
Telephone Number	:	562-387-4106
Fax Number	:	562-387-4106

Provider Business Practice Location Address
First Line	:	1777 N BELLFLOWER BLVD STE 102
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4019
Country	:	US
Telephone Number	:	949-805-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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